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Recurrence of inguinal hernia and scrotal edema due to dialysate leakage through the processus vaginalis: clinical case.

par Calderon Plazarte, Victor;Taghavi, Maxime ;Al Barajraji, Moncef ;El Khoury, Michael Abdo Jefferson;Mboti, Freddy ;Noels, Johanna
Référence Bulletin de la Dialyse à Domicile, 8, 4, page (315-321)
Publication Publié, 2025-12-01

Article révisé par les pairs

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Résumé :

Peritoneal dialysis is a therapeutic option for end-stage kidney disease patients that offers a better quality of life Peritoneal dialysis is a treatment option for patients with stage V chronic kidney disease that offers a better quality of life compared to hemodialysis. Abdominal wall hernias and scrotal edema are potential complications of peritoneal dialysis that may require discontinuation of the technique. However, radiological diagnosis and treatment of the hernia allow peritoneal dialysis to be resumed. We report here the case of a 72-year-old patient presenting with unilateral recurrence of an inguinal hernia with scrotal edema after bilateral open repair due to leakage of peritoneal dialysis fluid through a patent processus vaginalis, and we reviewed the existing literature. The literature reports that 4 to 14% of peritoneal dialysis patients develop an abdominal hernia and that dialysate leakage or scrotal edema, which are rarer, are often associated with an indirect inguinal hernia or a persistent patent processus vaginalis. Several risk factors have been identified: age, male gender, obesity, polycystic kidney disease, history of hernia, and high dialysate volumes. The diagnosis is based mainly on peritoneal computed tomography. Management may be conservative, but surgical repair using a tension-free technique, preferably according to Lichtenstein, is recommended in cases of confirmed primary or recurrent hernia. The optimal time to resume peritoneal dialysis remains variable, but is most often between 2 and 6 weeks.